976 ANAPHYLAXIS AND ANAPHYLACTOID REACTIONS 



cord with the change assumed by Simonds to occur in the intact liver, namely, a constriction 

 of the hepatic veins sufficient to reduce the return flow to the heart. Manwaring' would 

 exclude the factor of vasoconstriction and ascribe the mechanical factor to perivascular 

 edema. More important in his opinion is the explosive formation in the liver of a histamine- 

 like vasodepressor substance. 



The blood-cell changes are variable. Bose^ demonstrated a relative eosinophilia in guinea 

 pigs when hypersensitive. In shock, leukopenia occurs in various animals. It occurs in dogs, 

 apparently due to accumulation of leukocytes in the lung capillaries (Webb) ,3 and is said by 

 Dean and Webb'' to be followed by leukocytosis. Richet and his colleagues^ state that in dogs 

 there is an increase in the number of erythroblasts. Zunz^ found thrombopenia in dogs, and 

 Piana^ reports large numbers of platelets in the capillaries of the liver. 



A decrease in coagulability of the blood is especially marked in dogs and guinea pigs 

 less so in other animals. This has been studied by Biedl and Kraus,^ Achard and Aynaud,' 

 Lee and Vincent,"* Pepper and Krumbhaar," and others. Gahringer'^ finds that in pigeons the 

 decrease is preceded by a marked increase. This has been confirmed by Reed and Lamson.'^ 

 Bulger'4 concludes that the decrease in coagulability is "due to changes in that stage of the 

 coagulative process at which thrombin is formed through the interaction of prothrombin, 

 calcium, thromboplastin and antithrombin (?). These changes are probably due to vari- 

 ations in thromboplastin." 



Gaseous metabolism is increased in the convulsive stage and decreased in the asphyxial 

 stage of shock (Abderhalden and Wertheimer).'^ The body temperature first rises (Richet) 

 and then falls precipitously (Biedl and Kraus). Hirsch and Williams'* report a slight increase 

 in blood sugar. McCullough and O'Neill'' demonstrated marked increase in blood sugar and 

 lactic acid. Zeckwer and Goodell'^ found marked hyperglycemia in bacterial anaphylaxis 

 even when the organisms produced hypoglycemia in normal animals. The asphyxia is also 

 associated with acidosis (Hirsch and Williams) and with a decrease of surface tension (Zunz 

 and LaBarre).'' 



' Manwaring, W. H., and Kusama, Y.: J. Immunol., 2, 157. 1917; Mamvaring, W. H., and 

 Crowe, H. E.: ihid., 2, 517. 1917. 



^ Bose, J. P.: Calcutta M. J., 18, 377. 1923. 



3 Webb, P. A.: /. Path. &- Bad., 27, 79. 1924. 



■» Dean, H. R., and Webb, P. A.: ibid., p. 65. 1924. 



5 Richet, C, Brodin, P., and St. Girons, F.: Compt. rend. Acad, de sc, 168, 369. 1919; see also 

 Brodin, P., and Richet yZ/j; Compt. rend. Soc. de biol., 84, 298. 192 1. 



^Zunz, E., and Geerthruyden-Bernard, D.: Inst. d. Therap., p. 79. Bruxelles, 1922. 



7 Plana, C.: Riforma med., 39, 702. 1923. * Biedl, A., and Kraus, R.: loc. cit. 



' Achard, C, and Aynaud, M.: Compt. rend. Soc. de biol., 67, 83. 1909. 

 '"Lee, R. I., and Vincent, B.: /. Med. Research, 32, 445. 1915. 

 " Pepper, O. P. H., and Krumbhaar, E. B.: /. Infect. Dis., 14, 476. 1914. 

 " Gahringer, J. E.: loc. cit. 



'^ Reed, C. I., and Lamson, R. W.: /. Immunol., 13, 433. 1927. 

 '■t Bulger, H. A.: /. Infect. Dis., 23, 522. 1918. 



'5 Abderhalden, E., and Wertheimer, A.: Pfliiger's Arch.f. d. ges. Physiol., 195, 487. 1922. 

 ■'' Hirsch, E. F., and Williams, J. L.: /. Infect. Dis., 30, 259. 1922. 

 "McCullough, M., and O'Neill, F. I.: ibid., 37, 225. 1925. 

 '* Zeckwer, I. T., and Goodell, H.: /. Exper. Med., 42, 57. 1925. 

 ■» Zunz, E., and la Barre, J.: Compt. rend. Soc. de biol., 90, 658. 1924. 



